Differences found in patient characteristics of migrant tuberculosis sub-populations within low TB incidence European countries, 2014-2020

Introduction: In low TB incidence countries, prevention and care activities addressing migrants are essential for TB control. Understanding characteristics of the migrant TB patient population is important for planning and providing appropriate care. This study aims to inform prevention and care strategies by describing characteristics of migrant TB subpopulations in Europe to understand whether differences exist in their patient profiles. Methods: This cross-sectional descriptive study among migrant TB patients reported to the European Surveillance System (2014-2020) from 23 low incidence European countries describes characteristics of different subgroups, according to TB epidemiological indicators and interval between arrival and notification. Results: Patients from very high TB incidence countries had the highest proportion of people-living-with-HIV (7%) and lowest pulmonary TB proportion (57%). Patients from high incidence countries had the highest proportion with previous TB diagnosis (14%), first line (12%) and multidrug (6%) resistances. Compared to all patients, patients arriving from the 10 countries with the highest crude incidence rates in the destination countries, were on average 9 years younger (median age 25 vs 34) and more often male (M:F ratio 2.6 vs. 1.8). Patients notified <2 years after arrival had higher proportions with PTB (67%), people-living-with-HIV(7%) and MDR-TB (4%). Discussion: Unique patterns in patient characteristics were observed which varied by migrant origin and destination. Improving European TB preparedness within the context of migration requires timely and complete international data alongside continuous access to quality TB care, not only at entry, and expanded opportunities for diagnosis given levels of extrapulmonary TB observed.